Amy Knoblock-Hahn - Academia.edu (original) (raw)

Papers by Amy Knoblock-Hahn

Research paper thumbnail of Socio-ecological approach to the development of user-centered design consumer health technologies for adolescent obesity self-management

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 5, 2013

ABSTRACT Background: Multiple levels of influence from the socio-ecological model are thought to ... more ABSTRACT Background: Multiple levels of influence from the socio-ecological model are thought to contribute to the increased prevalence of adolescent obesity. Consumer health technologies (CHT) have been shown to be effective for self-management of behaviors that contribute to obesity. The use of the mobile phone platform is particularly promising. Adolescents are heavy users of mobile phones and other technologies, yet their specific needs and preferences have not been assessed. Objective/Purpose: Identify key goals, functionality, and design requirements for smart phone or web-based applications aimed at promoting evidence-based behaviors for adolescent obesity self-management. Methods: Focus groups with overweight and obese adolescents and in-depth interviews with pediatricians and parents of overweight and obese adolescents were utilized as part of a user-centered design approach for the development of adolescent obesity CHT applications. Constructs from the Unified Theory of Acceptance and Use of Technology, Social-Cognitive Theory, and Persuasive Design Theory were used to develop focus group and interview protocols. Results: Parents and adolescents expressed intent to co-use CHT applications. Pediatricians expressed intent to adopt limited use of CHT applications into practice. Adolescents, parents, and pediatricians perceived the ability to use CHT applications for self-monitoring of food and exercise behaviors as most useful for weight management. The ability to engage in social networking, learn how to cook, and receive guidance on restaurant menu selection were additional features of CHT applications perceived to be useful by parents and adolescents. Adolescents perceived interactive persuasive design features to motivate them to continue to engage in healthy weight management behaviors. Discussion/Conclusions: Adoption of CHT adolescent obesity applications at multiple levels of the socio-ecological model may prevent further adolescent obesity severity as well as result in reciprocal determinism of some weight management behaviors between co-users. Prototype and usability testing are required next steps before such effectiveness can be determined.

Research paper thumbnail of Barriers and Benefits to CHT Use in Overweight and Obese Adolescents

Research paper thumbnail of Cultural Competence in Dietetics Education

Journal of The American Dietetic Association, Sep 1, 2009

Program directors of accredited dietetics educational programs for registered dietitians were sur... more Program directors of accredited dietetics educational programs for registered dietitians were surveyed to determine the extent to which cultural competency is currently being addressed in their curricula. A total of 153 of 461 responses were collected over the 10-week survey period, yielding a 33% response rate. Responses were obtained from 20 of the 50 coordinated program directors (40%); 58 of the 209 didactic program directors (28%); and 61 of the 232 dietetic internship directors (26%). Fourteen participants identified themselves as "other." Results of this study showed a discrepancy between what program directors thought should be included in curriculum related to cultural competence and what they are currently providing. Content areas related to knowledge were more likely to be included than those related to skills and attitudes. Fewer than 20% of all dietetics education programs responding to the survey teach a required course in cultural competency.

Research paper thumbnail of Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action

Journal of the Academy of Nutrition and Dietetics, Jun 1, 2020

NDERSTANDING FOOD AND water systems is critically important for the practice of nutrition and die... more NDERSTANDING FOOD AND water systems is critically important for the practice of nutrition and dietetics. This is especially true as growing populations, rising per capita demand for nutrient-rich foods, and climate change pose mounting challenges for meeting global nutrition targets. Food and water systems include the resources, people, and activities involved in the production, processing, packaging, distribution, purchasing, preparation, consumption, discard, and safety of food and water, as well as the complex relationships among these processes. 1-3 The concept of sustainable, resilient, and healthy food and water systems (henceforth "sustainable food systems") describes systems where "individuals have equitable and optimal access to food and water, both now and in the future." 4(p475) Sustainability is multidimensional, with sustainable food systems at the intersection of multiple domains including nutrition and health; environmental stewardship; economic vitality; and social, cultural, and ethical capital. 4 Sustainability considers both the long-term viability of the food system and current issues, such as the global burden of hunger and malnutrition, 5 unequal economic access to nutritious foods, 6 high rates of food loss and waste, 7 the precariousness of freshwater supplies for agricultural irrigation, 8 and equity issues for food systems workers. 9,10 Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered

Research paper thumbnail of The Development of a Food Waste Audit Tool for Foodservice Facilities

Journal of Nutrition Education and Behavior, Jul 1, 2016

schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome ... more schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome Measures and Analysis: A two-tailed paired t-test was used to determine differences between baseline and post-implementation compliance rates. Results: School food and beverage offerings were highly variable. School compliance for offering a la carte foods increased from 36.0% to 90.0% (p¼0.0001). All a la carte beverages adhered to the new standards compared to only two thirds (65.5%) of vending machine beverages. Conclusions and Implications: It is likely that rural schools will need additional training and technical assistance to fully implement the national standards as compliance was not 100% in this sample. While compliance greatly improved between 2014 and 2015 to meet the Smart Snacks regulation, the types of foods offered did not change as schools sold reformulated chips, baked goods and frozen novelties to meet the standards post-implementation.

Research paper thumbnail of Improving Food Security, Nutrition, and Healthy Family Behaviors Through the Registered Dietitian Parent Empowerment and Supplemental Food Pilot Program

Journal of the Academy of Nutrition and Dietetics, Sep 1, 2016

Research paper thumbnail of Technological support tools for pediatric obesity self-management: A user-centered design approach for overweight and obese adolescents age 12 -- 17 years

Research paper thumbnail of Barriers and Benefits to CHT Use in Overweight and Obese Adolescents

Research paper thumbnail of Effectiveness of Clinical Video Telehealth plus Telephone Coaching for Weight Loss and Weight Loss Behaviors in Veterans

Journal of the Academy of Nutrition and Dietetics, 2016

Learning Outcome: Participants will be able to identify public health guidelines containing dieta... more Learning Outcome: Participants will be able to identify public health guidelines containing dietary sugar recommendations and increase their understanding of the strengths and limitations of the guidelines, their recommendations and the corresponding evidence. Background: The relationship between sugar and health is being actively researched and translated into dietary recommendations by authoritative health organizations. Recommendations range dramatically, making it confusing to policy makers, healthcare professionals and consumers. The purpose of this research was to systematically identify and evaluate public health guidelines (PHGs) providing sugar recommendations. Methods: MEDLINE, EMBASE, Web of Science and four grey literature sources were searched to identify potential PHGs. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and a modified Oxford Center for Evidence-Based Levels of Evidence were used to assess the quality of the guidelines and evidence used to support recommendations.

Research paper thumbnail of Improving Food Security, Nutrition, and Healthy Family Behaviors Through the Registered Dietitian Parent Empowerment and Supplemental Food Pilot Program

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of The Development of a Food Waste Audit Tool for Foodservice Facilities

Journal of Nutrition Education and Behavior, 2016

schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome ... more schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome Measures and Analysis: A two-tailed paired t-test was used to determine differences between baseline and post-implementation compliance rates. Results: School food and beverage offerings were highly variable. School compliance for offering a la carte foods increased from 36.0% to 90.0% (p¼0.0001). All a la carte beverages adhered to the new standards compared to only two thirds (65.5%) of vending machine beverages. Conclusions and Implications: It is likely that rural schools will need additional training and technical assistance to fully implement the national standards as compliance was not 100% in this sample. While compliance greatly improved between 2014 and 2015 to meet the Smart Snacks regulation, the types of foods offered did not change as schools sold reformulated chips, baked goods and frozen novelties to meet the standards post-implementation.

Research paper thumbnail of Socio-ecological approach to the development of user-centered design consumer health technologies for adolescent obesity self-management

Background: Multiple levels of influence from the socio-ecological model are thought to contribut... more Background: Multiple levels of influence from the socio-ecological model are thought to contribute to the increased prevalence of adolescent obesity. Consumer health technologies (CHT) have been shown to be effective for self-management of behaviors that contribute to obesity. The use of the mobile phone platform is particularly promising. Adolescents are heavy users of mobile phones and other technologies, yet their specific needs and preferences have not been assessed. Objective/Purpose: Identify key goals, functionality, and design requirements for smart phone or web-based applications aimed at promoting evidence-based behaviors for adolescent obesity self-management. Methods: Focus groups with overweight and obese adolescents and in-depth interviews with pediatricians and parents of overweight and obese adolescents were utilized as part of a user-centered design approach for the development of adolescent obesity CHT applications. Constructs from the Unified Theory of Acceptance ...

Research paper thumbnail of Structure, localization and function of the chick cerebellar kainate binding protein, a putative receptor/channel

Research paper thumbnail of Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of Development and Pilot Testing of the Prioritizing Food Security Solutions Toolkit

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of Development and Implementation of a Sustainable, Resilient, and Healthy Food and Water Systems Curriculum for Dietetic Interns

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of The RD Parent Empowerment and Supplemental Food Pilot Program for Improved Food Security, Nutrition, and Family Behaviors

Journal of the Academy of Nutrition and Dietetics, Jan 5, 2016

Research paper thumbnail of Integrative Nutrition and Health Models Targeting Low-Income Populations: A Pilot Intervention in Three Food Banks

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of A Balanced Approach to Understanding the Science of Antibiotics in Animal Agriculture

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of Perceptions of Adolescents with Overweight and Obesity for the Development of User-Centered Design Self-Management Tools within the Context of the Chronic Care Model: A Qualitative Study

Journal of the Academy of Nutrition and Dietetics, 2015

The Chronic Care Model (CCM) is helpful to illustrate multiple levels of influence in the managem... more The Chronic Care Model (CCM) is helpful to illustrate multiple levels of influence in the management of chronic disease, such as overweight and obesity in adolescents. Unfortunately, various constraints create gaps in the management process activities performed within the CCM. Consumer health technologies (CHT) may serve as a linkage between adolescents with overweight or obesity, their parents, and their pediatricians. To conduct formative research to qualitatively identify views of adolescents with overweight and obesity on use of consumer health technologies to manage weight loss across chronic care management settings. As part of a multi-perspective qualitative study, 10 focus groups were conducted with adolescents with overweight and obesity. Forty-eight adolescents (15 male, 33 female) aged 12 to 17 years who were current participants of an intensive lifestyle change camp in the summer of 2012 participated in focus groups. All adolescents were classified as overweight (21%) or obese (79%) according to body mass index (BMI) for age charts published by the Centers for Disease Control and Prevention. All focus groups were recorded, transcribed verbatim, and checked for accuracy. Predefined and open coding were used to analyze transcripts for emerging themes. Adolescents perceive CHT, with its functional requirements of assistance with restaurant food selection, teaching cooking skills, and providing encouragement and motivation, to be helpful with overweight and obesity self-management. Desired features to carry out these functional requirements included avatars, self-monitoring capabilities, social networking, and rewards. Our findings largely agree with previously reported parental perceptions of the benefit of CHT for adolescent overweight and obesity self-management and strengthen support for the design and implementation of CHT within the CCM.

Research paper thumbnail of Socio-ecological approach to the development of user-centered design consumer health technologies for adolescent obesity self-management

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 5, 2013

ABSTRACT Background: Multiple levels of influence from the socio-ecological model are thought to ... more ABSTRACT Background: Multiple levels of influence from the socio-ecological model are thought to contribute to the increased prevalence of adolescent obesity. Consumer health technologies (CHT) have been shown to be effective for self-management of behaviors that contribute to obesity. The use of the mobile phone platform is particularly promising. Adolescents are heavy users of mobile phones and other technologies, yet their specific needs and preferences have not been assessed. Objective/Purpose: Identify key goals, functionality, and design requirements for smart phone or web-based applications aimed at promoting evidence-based behaviors for adolescent obesity self-management. Methods: Focus groups with overweight and obese adolescents and in-depth interviews with pediatricians and parents of overweight and obese adolescents were utilized as part of a user-centered design approach for the development of adolescent obesity CHT applications. Constructs from the Unified Theory of Acceptance and Use of Technology, Social-Cognitive Theory, and Persuasive Design Theory were used to develop focus group and interview protocols. Results: Parents and adolescents expressed intent to co-use CHT applications. Pediatricians expressed intent to adopt limited use of CHT applications into practice. Adolescents, parents, and pediatricians perceived the ability to use CHT applications for self-monitoring of food and exercise behaviors as most useful for weight management. The ability to engage in social networking, learn how to cook, and receive guidance on restaurant menu selection were additional features of CHT applications perceived to be useful by parents and adolescents. Adolescents perceived interactive persuasive design features to motivate them to continue to engage in healthy weight management behaviors. Discussion/Conclusions: Adoption of CHT adolescent obesity applications at multiple levels of the socio-ecological model may prevent further adolescent obesity severity as well as result in reciprocal determinism of some weight management behaviors between co-users. Prototype and usability testing are required next steps before such effectiveness can be determined.

Research paper thumbnail of Barriers and Benefits to CHT Use in Overweight and Obese Adolescents

Research paper thumbnail of Cultural Competence in Dietetics Education

Journal of The American Dietetic Association, Sep 1, 2009

Program directors of accredited dietetics educational programs for registered dietitians were sur... more Program directors of accredited dietetics educational programs for registered dietitians were surveyed to determine the extent to which cultural competency is currently being addressed in their curricula. A total of 153 of 461 responses were collected over the 10-week survey period, yielding a 33% response rate. Responses were obtained from 20 of the 50 coordinated program directors (40%); 58 of the 209 didactic program directors (28%); and 61 of the 232 dietetic internship directors (26%). Fourteen participants identified themselves as "other." Results of this study showed a discrepancy between what program directors thought should be included in curriculum related to cultural competence and what they are currently providing. Content areas related to knowledge were more likely to be included than those related to skills and attitudes. Fewer than 20% of all dietetics education programs responding to the survey teach a required course in cultural competency.

Research paper thumbnail of Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action

Journal of the Academy of Nutrition and Dietetics, Jun 1, 2020

NDERSTANDING FOOD AND water systems is critically important for the practice of nutrition and die... more NDERSTANDING FOOD AND water systems is critically important for the practice of nutrition and dietetics. This is especially true as growing populations, rising per capita demand for nutrient-rich foods, and climate change pose mounting challenges for meeting global nutrition targets. Food and water systems include the resources, people, and activities involved in the production, processing, packaging, distribution, purchasing, preparation, consumption, discard, and safety of food and water, as well as the complex relationships among these processes. 1-3 The concept of sustainable, resilient, and healthy food and water systems (henceforth "sustainable food systems") describes systems where "individuals have equitable and optimal access to food and water, both now and in the future." 4(p475) Sustainability is multidimensional, with sustainable food systems at the intersection of multiple domains including nutrition and health; environmental stewardship; economic vitality; and social, cultural, and ethical capital. 4 Sustainability considers both the long-term viability of the food system and current issues, such as the global burden of hunger and malnutrition, 5 unequal economic access to nutritious foods, 6 high rates of food loss and waste, 7 the precariousness of freshwater supplies for agricultural irrigation, 8 and equity issues for food systems workers. 9,10 Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered

Research paper thumbnail of The Development of a Food Waste Audit Tool for Foodservice Facilities

Journal of Nutrition Education and Behavior, Jul 1, 2016

schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome ... more schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome Measures and Analysis: A two-tailed paired t-test was used to determine differences between baseline and post-implementation compliance rates. Results: School food and beverage offerings were highly variable. School compliance for offering a la carte foods increased from 36.0% to 90.0% (p¼0.0001). All a la carte beverages adhered to the new standards compared to only two thirds (65.5%) of vending machine beverages. Conclusions and Implications: It is likely that rural schools will need additional training and technical assistance to fully implement the national standards as compliance was not 100% in this sample. While compliance greatly improved between 2014 and 2015 to meet the Smart Snacks regulation, the types of foods offered did not change as schools sold reformulated chips, baked goods and frozen novelties to meet the standards post-implementation.

Research paper thumbnail of Improving Food Security, Nutrition, and Healthy Family Behaviors Through the Registered Dietitian Parent Empowerment and Supplemental Food Pilot Program

Journal of the Academy of Nutrition and Dietetics, Sep 1, 2016

Research paper thumbnail of Technological support tools for pediatric obesity self-management: A user-centered design approach for overweight and obese adolescents age 12 -- 17 years

Research paper thumbnail of Barriers and Benefits to CHT Use in Overweight and Obese Adolescents

Research paper thumbnail of Effectiveness of Clinical Video Telehealth plus Telephone Coaching for Weight Loss and Weight Loss Behaviors in Veterans

Journal of the Academy of Nutrition and Dietetics, 2016

Learning Outcome: Participants will be able to identify public health guidelines containing dieta... more Learning Outcome: Participants will be able to identify public health guidelines containing dietary sugar recommendations and increase their understanding of the strengths and limitations of the guidelines, their recommendations and the corresponding evidence. Background: The relationship between sugar and health is being actively researched and translated into dietary recommendations by authoritative health organizations. Recommendations range dramatically, making it confusing to policy makers, healthcare professionals and consumers. The purpose of this research was to systematically identify and evaluate public health guidelines (PHGs) providing sugar recommendations. Methods: MEDLINE, EMBASE, Web of Science and four grey literature sources were searched to identify potential PHGs. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and a modified Oxford Center for Evidence-Based Levels of Evidence were used to assess the quality of the guidelines and evidence used to support recommendations.

Research paper thumbnail of Improving Food Security, Nutrition, and Healthy Family Behaviors Through the Registered Dietitian Parent Empowerment and Supplemental Food Pilot Program

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of The Development of a Food Waste Audit Tool for Foodservice Facilities

Journal of Nutrition Education and Behavior, 2016

schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome ... more schools with higher than 50% of student eligibility for free and reduced priced lunches. Outcome Measures and Analysis: A two-tailed paired t-test was used to determine differences between baseline and post-implementation compliance rates. Results: School food and beverage offerings were highly variable. School compliance for offering a la carte foods increased from 36.0% to 90.0% (p¼0.0001). All a la carte beverages adhered to the new standards compared to only two thirds (65.5%) of vending machine beverages. Conclusions and Implications: It is likely that rural schools will need additional training and technical assistance to fully implement the national standards as compliance was not 100% in this sample. While compliance greatly improved between 2014 and 2015 to meet the Smart Snacks regulation, the types of foods offered did not change as schools sold reformulated chips, baked goods and frozen novelties to meet the standards post-implementation.

Research paper thumbnail of Socio-ecological approach to the development of user-centered design consumer health technologies for adolescent obesity self-management

Background: Multiple levels of influence from the socio-ecological model are thought to contribut... more Background: Multiple levels of influence from the socio-ecological model are thought to contribute to the increased prevalence of adolescent obesity. Consumer health technologies (CHT) have been shown to be effective for self-management of behaviors that contribute to obesity. The use of the mobile phone platform is particularly promising. Adolescents are heavy users of mobile phones and other technologies, yet their specific needs and preferences have not been assessed. Objective/Purpose: Identify key goals, functionality, and design requirements for smart phone or web-based applications aimed at promoting evidence-based behaviors for adolescent obesity self-management. Methods: Focus groups with overweight and obese adolescents and in-depth interviews with pediatricians and parents of overweight and obese adolescents were utilized as part of a user-centered design approach for the development of adolescent obesity CHT applications. Constructs from the Unified Theory of Acceptance ...

Research paper thumbnail of Structure, localization and function of the chick cerebellar kainate binding protein, a putative receptor/channel

Research paper thumbnail of Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of Development and Pilot Testing of the Prioritizing Food Security Solutions Toolkit

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of Development and Implementation of a Sustainable, Resilient, and Healthy Food and Water Systems Curriculum for Dietetic Interns

Journal of the Academy of Nutrition and Dietetics

Research paper thumbnail of The RD Parent Empowerment and Supplemental Food Pilot Program for Improved Food Security, Nutrition, and Family Behaviors

Journal of the Academy of Nutrition and Dietetics, Jan 5, 2016

Research paper thumbnail of Integrative Nutrition and Health Models Targeting Low-Income Populations: A Pilot Intervention in Three Food Banks

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of A Balanced Approach to Understanding the Science of Antibiotics in Animal Agriculture

Journal of the Academy of Nutrition and Dietetics, 2016

Research paper thumbnail of Perceptions of Adolescents with Overweight and Obesity for the Development of User-Centered Design Self-Management Tools within the Context of the Chronic Care Model: A Qualitative Study

Journal of the Academy of Nutrition and Dietetics, 2015

The Chronic Care Model (CCM) is helpful to illustrate multiple levels of influence in the managem... more The Chronic Care Model (CCM) is helpful to illustrate multiple levels of influence in the management of chronic disease, such as overweight and obesity in adolescents. Unfortunately, various constraints create gaps in the management process activities performed within the CCM. Consumer health technologies (CHT) may serve as a linkage between adolescents with overweight or obesity, their parents, and their pediatricians. To conduct formative research to qualitatively identify views of adolescents with overweight and obesity on use of consumer health technologies to manage weight loss across chronic care management settings. As part of a multi-perspective qualitative study, 10 focus groups were conducted with adolescents with overweight and obesity. Forty-eight adolescents (15 male, 33 female) aged 12 to 17 years who were current participants of an intensive lifestyle change camp in the summer of 2012 participated in focus groups. All adolescents were classified as overweight (21%) or obese (79%) according to body mass index (BMI) for age charts published by the Centers for Disease Control and Prevention. All focus groups were recorded, transcribed verbatim, and checked for accuracy. Predefined and open coding were used to analyze transcripts for emerging themes. Adolescents perceive CHT, with its functional requirements of assistance with restaurant food selection, teaching cooking skills, and providing encouragement and motivation, to be helpful with overweight and obesity self-management. Desired features to carry out these functional requirements included avatars, self-monitoring capabilities, social networking, and rewards. Our findings largely agree with previously reported parental perceptions of the benefit of CHT for adolescent overweight and obesity self-management and strengthen support for the design and implementation of CHT within the CCM.